Cell phones replaced land-based pagers at Richland Hospital in Richland Center, WI, when the area was hit by severe storms and flooding in late August.

"Like any technology, you can't always depend on ground-based communication, says Chuck Aber, MBA, senior assistant administrator and CFO." The land-based medical pager antenna took an electrical hit and reduced the capacity to transmit the signal as far as it normally can.

"Cell phones are improving all the time, so we tried to evaluate whether cell phones or the land-based pagers should be used, and we decided that the cell phone signal was stronger," Aber adds. "So for a few days we converted to cell phones to contact staff in emergency situations."

Because of the flooding, the medical pager antenna could not be serviced for about five days, he notes.

While the admission process at the hospital remained unchanged during the severe weather, he adds, the community was kept informed through radio and the efforts of a local government emergency group.

"We did an evaluation with the county emergency group to be aware of road closings so we could communicate to the community as far as providing information about road closures and alternate routes," Aber says.

About 92% of hospitals surveyed in 2003 and 2004 had revised their emergency response plans since Sept. 11, 2001, according to a recent report from the Centers for Disease Control and Prevention.

Nearly two-thirds of hospitals had addressed natural disasters and four types of terrorism incidents (biological, chemical, nuclear-radiological, and explosive-incendiary) in their plans.

More than three-quarters engaged in cooperative planning with other local health care facilities, while 52% had written agreements to be able to transfer patients during a disaster. Facilities accredited by The Joint Commission provided for these elements more frequently than nonaccredited hospitals.

Hospitals with 300 or more beds planned with other health facilities more frequently than those with fewer than 100 beds.

As to expansion of capacity during an emergency, 73% of hospitals had planned for cancellation of elective procedures and admissions, 65.5% had plans to establish an alternate care site, 60% had plans to make medical use of nonclinical space, 40% planned to convert their post-anesthesia care unit to accommodate intensive care needs, and 28% planned to activate decommissioned units.

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